Chapter 12

1. Chapter 12 • Child Abuse, Spousal Abuse, • and Sexual Assault

2. Child Abuse • 1,800,000 referrals alleging child abuse • 896,000 children determined to be abused per year in the U. S. • Physical abuse • Sexual abuse • General neglect • Emotional abuse

3. CHILD ABUSE ACCOMMODATION SYNDROME • Abuse • Secrecy • Accommodation • Disclosure • Suppression • All family members use defenses: • dissociation, repression, denial,minimization, externalization

4. CRISIS IN CHILD ABUSE • When secret is exposed, all go into crisis • Panic: • at losing child • losing parents • losing spouse • losing freedom

5. Interventions • Reporting is mandatory when suspected • Must educate and reframe as the only way to help family • Very few children get taken from home • Very few abusers go to jail • Must stop abuse and protect child • Must be nonjudgemental

6. Children may benefit from play therapy or family therapy when ready • Parents often : • Need group and individual counseling • Often need drug and alcohol education and 12 step • May have to deal with divorce issues

7. Adults who were sexually abused as children • Remembering childhood abuse may precipitate a crisis in adulthood • May need immediate containment of anxiety • May have lived in a delayed PTSD state for many years • May benefit from long term therapy and support groups

8. Elder Abuse • Domestic, institutional or self-neglect or self-abuse • Physical abuse, sexual abuse, emotional abuse, neglect and financial/fiduciary /material exploitation by someone who has a special relationship with the elder • About 1 out of 10 older Americans may be victims of abuse yeraly

9. Interventions • Mandatory reporting to Adult Protective Services • Multidisciplinary team approach needed • Public guardianships • Financial planning • Transportation • Assertiveness training • Self-advocacy

10. Intimate Partner Abuse and Domestic Violence • 52% of women and 66% of men have been physically assaulted • Intimate partner abuse more prevalent for women than men • 76% for women, 18% for men • D.V. leading cause of injury for women ages 15-44

11. 33% of women report being physically abused by intimate partner • 1 in 4 will be abused in her life • 97% of partner abuse is male to female • 3.3 million children are exposed to violence per year. • 40-60% of men who abuse women, abuse the children too.

12. Why women stay • Fear • Religious beliefs • Profamily societal values • Economically dependent • No place to go • Children need a father • No support system

13. Hopes he’ll change • Believes it is her fault • Sees no other options • Feels insecure and unable to take care of herself • denial

14. The Battering Cycle 1. Honeymoon Stage: The man and woman are getting along, are in love, and believe all is fine. 2. Tensions Stage: Man begins to complain, express stressful feelings, criticize. Woman walks on eggshells and tries to prevent him from getting angry. 3. Explosion Stage: Man screams, throws, punches, kicks, pushes, hits, and attempts to control woman. Woman thinking how to survive rather than escape. 4. Return to Honeymoon Stage: Man asks forgiveness, begs for another chance. Woman feels hopeful that he’ll change, and remembers his potential.

15. BATTERED WOMAN SYNDROME • After explosion, usually in such shock, doesn’t report it. • Over time, she uses defenses such as denial, introjection, learned helplessness, and numbing • She accommodates to avoid consequences of leaving

16. Interventions • Empower • Provide choices • Outpatient groups • Shelters • Restraining orders • Pressing charges • Reframe

17. The Batterer • Jealous • Sulks • Explosive temper • Critical • Difficulty expressing feelings • Drinks,uses drugs • Male role to be in charge

18. Contempt for women • Overly protective of partner • Controlling of partner’s behaviors and decisions • Breaks things, throws things • Hits, shoves, kicks partner when angry • Was physically and emotionally abused as a child

19. Interventions with batterer • Educate about types of abuse: • Intimidation • Isolation • Emotional abuse • Economic abuse • Sexual abuse • Using children

20. Threats • Using male privilege • Physical abuse • Power and control management groups • Anger and stress management

21. Rape • 1 in 4 women and 1 in 10 men will be sexually assaulted in their lifetime • Rape is not about sex, it is about control • Acquaintance rape is the most common type • Rapists are not usually psychotic or sick

22. Definition • Sexual act against one’s will. • It’s about consent. • Intercourse, oral sex, anal sex • It is a felony. • Most rapists don’t go to prison because it is not usually reported.

23. Rape Trauma Syndrome • Stage One: Immediate Crisis Reactions • Stage Two: Reorganization • Stage Three: Reintegration

24. Interventions • Create strong rapport • Reassure and validate for seeking help • Open ended questions to get a clear idea of what happened • Not necessarily a full graphic picture • Assess for symptoms that might necessitate physician involvement

25. Understand her frame of reference • Validate her feelings • Assure her it wasn’t her fault • Educate about PTSD and RTS • Empower: move her from victim to survivor • Reframe as much as possible

26. Support groups • EMDR • Self-defense classes • Medical exam • Legal intervention (when she wants to)